ABSTRACT
Objectives: To investigate the early diagnostic value of neutrophil gelatinase-associated apolipoprotein (NGAL) on contrast induced nephropathy (CIN) in patients after percutaneous coronary intervention (PCI). Methods: A total of 200 patients received coronary angiography (CAG) and PCI in our hospital from 2016-01 to 2017-02 were enrolled and the research included in 2 groups: CIN group, 23 and Non-NCI group, according to 4:1 ratio, 92 patients without NCI. Serum levels of creatinine, blood and urine levels of NGAL were examined and compared at pre-operation and 4 h, 24 h, 48 h and 72 h after the operation between 2 groups. Results: All patients received CAG and CIN occurred in 23/200 (11.5%) patients. Compared with Non-CIN group, CIN group had more patients with elder age, more smokers and diabetes, P<0.05. Pre-operative blood and urine NGAL were both at normal level and it was similar between 2 groups, P>0.05. In CIN group, urine NGAL was significantly increasing at 4 h after operation and gradually increasing to 72 h after operation; blood NGAL was significantly increasing at 4 h after operation, it began decreasing at 24 h after operation and remained a relatively high level at 72 h after operation; post-operative blood and urine levels of NGAL were different from pre-operative condition at each time points, all P<0.05. In Non-CIN group, post-operative blood and urine levels of NGAL were similar to pre-operative condition, P>0.05. Post-operative blood and urine NGAL were different at the same time point between 2 groups, P<0.01. AUC of ROC for post-operative urine NGAL at 4h, 24h, 48h and 72h were 0.908, 0.926, 0.931 and 0.957 respectively, the sensitivity and specificity for CIN diagnosis were 91.3% and 100% at 4 time points; AUC of ROC for post-operative blood NGAL at 4 h and 24 h were 0.964 and 0.913, the sensitivity and specificity for CIN diagnosis were 87.3% and 100% at both time points. Conclusions: Blood and urine levels of NGAL may reflect renal function changes earlier than serum creatinine in CAG/PCI patients, it had the higher sensitivity and specificity for CIN diagnosis and could be used as the early predictor for CIN occurrence.
ABSTRACT
Objective To evaluate the homogeneity of the proficiency test samples to verify whether it meets the requirements of the comparison in international reference laboratory.Methods According to the Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing (CNAS-GL03),14 biochemical indexes including ALT,AST,ALP,GGT,CK,LDH,TP,T-Bil,Urea,Cr,UA,Glu,TG and TC in the past three years (from 2014 to 2016)were tested by the Roche detection system Modular P800 Biochemical analyzer.The mean ((x)),standard deviation (s)and coefficient of variation (CV)of the samples were calculated.One-way analysis of variance (ANOVA)was performed and the guideline of Ss ≤0.3σ was used to evaluate the between-bottle differences.Results The results showed that the CVs of AST in RELA 2014A and B were higher than 2.0％.The CVs of CK were over 2％ in all tests except for RELA 2016B.The results of ANOVA for RELA samples demonstrated that the F value of CK was over the critical value 4.39,which was statistically significant (P ＜ 0.05).The F values of the ALT and T-Bil in 2015B and the Cr in 2014A were also over 4.39 (P ＜ 0.05) respectively,while the F values of other measurements were less than the critical value of F,indicating there was no statistical significance (P ＞ 0.05).The CK measurement data Ss ＞ 0.3σ in all the samples by the guideline of Ss ≤ 0.3σ,suggesting that there was a between-bottle difference in CK.The other indexes were Ss ≤ 0.3σ,showing no between-bottle difference in those items.Conclusion There were significant differences between the bottles of the CK item in the past three years,and the homogeneity of all the other items in the samples could meet the requirements of Proficiency Testing for the international reference laboratory.